Xofigo (Radium 223) to take with anything else as PSA levels have rocketed since coming off hormone treatment?

[Luucy]

My father is hormone resistant and been fighting prostate cancer since 2013.

He is 82, a recent scan showed his cancer hasn't spread to organs so has been approved to try Radium 223.

His PSA levels have rocketed to 400 which is higher than when he had been on any hormone treatment, which he was taken off as PSA levels had gone up but not as much.

Should he go back on them as if his PSA levels keep rising, taking Radium 223 on its own doesn't seem enough to keep things at bay?

His doctor says one step at a time but I feel he should look at chemo too?

Although my father is reluctant to go down this route.

Any advice would be appreciated thanks.

[JLS1]

Has he had Zytiga yet? He can do that along with the Xofigo, as long as he also has a bone strengthener like Xgeva.

[Luucy in reply to JLS1]

He's had Enzalutamide, not sure if he can have zytiga, will look into.

We are in UK.

[Tall_Allen]

He should be taking shots of Lupron or similar with it. He should not take Zytiga with it. There is a clinical trial now that includes enzalutamide, Radium 223 and a bone strengthening agent.

[Celtic]

Hello Luucy, I was interested to see your post as we’re also in the UK and my husband has just embarked on Zofigo (Radium 223).

Like your father, hubby is also in his 80’s and was diagnosed around the same time. He had been taking Zytiga (alongside the steroid, Prednisolone) for about a year until recently when it was stopped due to continually rising PSA (20 - he has always been in lowish figures) and scan revealing further cancer spread into bones. He has continued 3-monthly Zoladex shots throughout. He had his first of six Xofigo infusions 3 weeks ago. He was also supposed to have started monthly infusions of Zolendronic Acid just a week before but they wouldn’t do it until he had his dental appointment the following day. We have now delayed starting the latter as he was feeling very poorly following the Zofigo infusion - leg pain so bad that he couldn’t walk, resorting to 2 sticks to get him around the house, plus he feels nauseous and off his food. The last couple of days have seen an improvement so hoping for a better experience following the next infusion. Still don’t know what to do about starting the bone protection with its warning of potential fractures, kidney damage etc on top of his latest experience.. He wouldn’t have been able to get to the hospital for the treatment in the last couple of weeks anyway.

Whereabouts is your father being treated?

We are in Surrey and hubby is under St Luke’s, Guildford. I’m sorry I’m not knowledgeable enough to offer you the advice you asked for, but you’ve come to the right place because there are so many wonderfully knowledgeable and helpful souls here.

[Luucy in reply to Celtic]

Sorry to hear about your hubby, I really hope his next infusion goes a bit better.

It is all such a worry isn't it, my father has his first one tomorrow, as long as his blood test comes back ok.

My father had been on enzulamine for several months, but this did make him extremely tired, so despite not being on anything, apart from the 3 monthly hormone injections, he has felt better with increased appetite and energy.

We will see how the Radium 223 goes, I suppose it gets to a point where quality of life has to take over gruelling treatments.

I wish your hubby all the best.

We are in Gloucestershire, he is being treated at Cheltenham General hospital.

[Celtic in reply to Luucy]

How is your Dad coping with the Radium 223 if he managed to have it,Luucy ?

[Luucy in reply to Celtic]

Hi thanks for the message.

He had his first injection on Wednesday and apart from feeling a bit tired all went very well, so will have to see how it goes as he has been told quite a lot of people don't complete the 6 injections due to issues with kidneys and or blood count.

[Celtic in reply to Luucy]

Thank you for the reply, Luucy, and I’m so pleased that at least your Dad’s blood test results enabled the Zofigo to go ahead. It sounds good news thus far and long may that continue. Lots of good luck wishes to him and to you.

[Luucy in reply to Celtic]

Hi how is your hubby getting on?

My father unfortunately hasn't been able to have his 2nd Radium injection as his platelets and white blood cells are low.

This has been a blow for him and he is not sure what to do next.

[Celtic in reply to Luucy]

So sorry to hear that, Luucy, especially as your father seemed to tolerate the first infusion so well.

My hubby is having his 3rd Radium 223 infusion tomorrow. His latest blood test last week did show raised white cells but it was put down to him feeling low with a cough virus. We’ll obviously have to wait for the next blood test in a few weeks time to see if there is an improvement and thus confirm the virus as the cause. The severe pain following his first infusion has subsided but the nausea persists. There is a medication that works but it’s causing constipation - he feels he can’t win!

I do wish I had the experience to help in your father’s situation but I see you have raised it under a new post so hopefully you will get some helpful replies. Lots of good luck wishes.

[j-o-h-n]

Hang on Luucy, Luucy hang on... Give Dad my best wishes....

Good Luck, Good Health and Good Humor

j-o-h-n Friday 02/07/2020 8:07 PM EST

[Luucy]

Update with my father. His blood test today revealed he won't be able to have the next Radium 223 dose.

His platelets are 76 and need to be 100.

He will have to go back to he hospital next week for another blood test, but not sure what the options are now.